Coronavirus, Pregnancy, and Breastfeeding: A Message for Patients from ACOG

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COVID-19 Vaccination if You Are Pregnant or Breastfeeding

People getting a vaccination to prevent pandemic concept. Woman in medical face mask receiving a dose of immunization coronavirus vaccine from a nurse at the medical center hospital

The Society for Maternal-Fetal Medicine (SMFM) and other pregnancy experts recommend that pregnant and lactating people be vaccinated against COVID-19. Vaccination is the best way to reduce the risks of COVID-19 infection and COVID-related complications for both you and your baby.

As of January 2022, the Pfizer, Moderna, and Johnson & Johnson (J&J) COVID-19 vaccines are available for use in the U.S. The Pfizer vaccine is FDA-approved for people ages 16 and older.

All adults are eligible to receive a single-dose Pfizer, Moderna, or J&J booster shot. Adolescents ages 12 and older are eligible to get a Pfizer booster.

Pfizer’s COVID-19 vaccine has been authorized for people at least 5 years old. 

The U.S. Food and Drug Administration amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine to:

  • Expand the use of a single booster dose to include use in individuals 12 through 15 years of age.
  • Shorten the time between the completion of primary vaccination of the Pfizer-BioNTech COVID-19 Vaccine and a booster dose to at least five months.

For those receiving the Pfizer and Moderna vaccines, the second dose is given 21 days (Pfizer) and 28 days (Moderna) after the first dose. 

Information for Pregnant Individuals

If you are pregnant or planning to become pregnant and are thinking about getting vaccinated, consider talking with your health care professional about the vaccine.

To help with your decision, you should consider the following key points:

  • What are the benefits of getting the COVID-19 vaccines during pregnancy?
  • Anyone can get the COVID vaccines free of charge regardless of immigration status or whether they have insurance. You may be asked for your social security number, but it is NOT required to get vaccinated.
  • The vaccines can help protect you from getting COVID-19. With the two-dose vaccines, you must get both doses for maximum effectiveness. It’s not yet known how long protection lasts.
  • Another potential benefit is that getting the vaccine while pregnant may help you pass COVID-19 antibodies to your baby. In numerous studies of vaccinated moms, antibodies were found in the umbilical cord blood of babies and in the mother’s breastmilk.
  • The Centers for Disease Control and Prevention (CDC), along with other federal partners, are monitoring people who have been vaccinated for serious side effects. So far, more than 139,000 pregnant people have been vaccinated. No unexpected pregnancy or fetal problems have occurred. There have been no reports of any increased risk of pregnancy loss, growth problems, or birth defects.
  • A safe vaccine is generally considered one in which the benefits of being vaccinated outweigh the risks. The current vaccines are not live vaccines. There is only a very small chance that they cross the placenta, so it’s unlikely that they even reach the fetus.
  • Vaccines don’t affect future fertility. The only people who should NOT get vaccinated are those who have had a severe allergic reaction to vaccines in the past or any vaccine ingredients.
  • Side effects may occur in the first 3 days after getting vaccinated. (1) These include mild to moderate fever, headache, and muscle aches. Side effects may be worse after the second dose of the Pfizer and Moderna vaccines. (3, 4) Fever should be avoided during pregnancy, especially in the first trimester. Those who develop a fever after vaccination can take acetaminophen (Tylenol). This medication is safe to use during pregnancy and does not affect how the vaccine works.

What are the known risks of getting COVID-19 during pregnancy?

About 1 to 3 per 1,000 pregnant women with COVID-19 will develop severe disease. Compared with those who aren’t pregnant, pregnant people infected by the COVID-19 virus:

  • Are 3 times more likely to need ICU care
  • Are 2 to 3 times more likely to need advanced life support and a breathing tube
  • Have a small increased risk of dying due to COVID-19
  • They may also be at increased risk of stillbirth and preterm birth. (6-8)

What is my risk of getting COVID-19?

Your risk of getting COVID-19 depends on the chance that you will come into contact with another infected person. The risk may be higher if you live in a community where there is a lot of COVID-19 infection or work in healthcare or another high-contact setting.

What is my risk for severe complications if I get COVID-19?

Data show that older pregnant women; those with preexisting health conditions, such as a body mass index higher than 35 kg/m2, diabetes, and heart disorders; and Black or Latinx women have an especially increased risk of severe disease and death from COVID-19. (6-8)

If you still have questions about the vaccines or need more information, ask your health care provider or go to the Centers for Disease Control and Prevention’s COVID-19 vaccine webpage.

Information for Breastfeeding/Lactating Individuals

The Society for Maternal-Fetal Medicine and other pregnancy experts recommend COVID-19 vaccination for people who are breastfeeding/lactating. You don’t have to delay or stop breastfeeding just because you get vaccinated. 

Getting Vaccinated

You can get vaccinated at any time during pregnancy. The CDC is committed to monitoring the vaccine’s safety for all individuals. Even after you’re fully vaccinated, it is important to follow the CDC’s guidance for wearing a mask indoors in areas where there are substantial or high rates of COVID-19 infection. 

Talk to A Midwife

At City of Oaks Midwifery, our goal is to help patients in Raleigh and the greater Triangle area feel safe and comfortable. Our Certified Nurse Midwives are here to answer any questions you might have about the COVID-19 vaccine. To schedule an appointment, call (919) 351-8253.

References

  1. Oliver SE, Gargano JW, Marin M, Wallace M, Curran KG, Chamberland M, et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Pfizer-BioNTech COVID-19 Vaccine — United States, December 2020. MMWR Morbidity and Mortality Weekly Report 2020;69.
  2. FDA Briefing Document. Janssen Ad26.COV2.S Vaccine for the Prevention of COVID-19. 2021. Accessed Mar 5, 2021; Available from: https://www.fda.gov/media/146217/download
  3. PFIZER-BIONTECH COVID-19 VACCINE [package insert] New York: Pfizer and Mainz, German: Biontech;2020.
  4. FDA Briefing Document. Moderna COVID-19 Vaccine. 2020. Accessed 2020, Dec 18; Available from: https://www.fda.gov/media/144434/download
  5. Gray KJ, Bordt EA, Atyeo C, Deriso E, Akinwunmi B, Young N, et al. COVID-19 vaccine response in pregnant and lactating women: a cohort study. Am J Obstet Gynecol 2021 Mar 24.
  6. Panagiotakopoulos L, Myers TR, Gee J, Lipkind HS, Kharbanda EO, Ryan DS, et al. SARS-CoV-2
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